Department of Reproductive and Developmental Medicine, Jessop Wing, University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Fertil Steril. 2013 Sep;100(3):825-30. doi: 10.1016/j.fertnstert.2013.05.007. Epub 2013 Jun 10.
To determine expression of integrins α₁, α₄, and αVβ₃ in the glandular and luminal epithelium, stroma, and cells in the blood vessel walls of the endometrium from women with recurrent implantation failure (RIF) and to determine if they are of prognostic value in determining pregnancy outcome.
Prospective nonrandomized study.
Department of reproductive medicine.
PATIENT(S): Forty-five women with RIF and six healthy fertile women were recruited. RIF was defined as the failure to conceive after the transfer of four good-quality embryos in three or more fresh or frozen cycles.
INTERVENTION(S): Endometrial biopsy samples were obtained from women with RIF and control women on days LH+7-LH+9 of the cycle. Expression of integrins α₁, α₄, and αVβ₃ was determined by immunohistochemistry.
MAIN OUTCOME MEASURE(S): A semiquantitative measurement of expression of each integrin protein in the luminal and glandular epithelium, stroma, and cells in the blood vessel walls was determined by H-score analysis.
RESULT(S): Expression of integrins α₁ and α₄ was greatest in the luminal and glandular epithelial cells and the cells in the blood vessel wall, and significantly higher expression of integrins α₁ and α₄ was seen in the glandular epithelium compared with the luminal epithelium (H-scores: α₁ 293 ± 15 and 180 ± 12, α₄ 287 ± 14 and 191 ± 11, respectively). Expression of αVβ₃ in the epithelium and blood vessels was also greater than in the stroma but there was no significant difference in expression of αVβ₃ in glandular and luminal epithelium. No significant difference in H-scores was seen for α₁, α₄, and αVβ3 expression in any of the endometrial compartments in tissue from women with RIF and control women. No significant difference in α₁, α₄, and αVβ₃ expression in any compartment was observed between those who achieved a clinical pregnancy after subsequent assisted conception treatment (n = 21) and those who were unsuccessful (n = 24).
CONCLUSION(S): RIF, when defined as failure to achieve a clinical pregnancy after the transfer of at least four good-quality embryos in three transfer cycles, is not associated with abnormal endometrial integrin expression. In addition, the expression of integrins α₁, α₄, and αVβ₃ appears to have no prognostic value in subsequent IVF treatment.
检测整合素α₁、α₄和αVβ₃在复发性植入失败（RIF）患者子宫内膜的腺上皮和腔上皮、基质和血管壁细胞中的表达，并确定其是否对预测妊娠结局具有预后价值。
前瞻性非随机研究。
生殖医学系。
招募了 45 名 RIF 患者和 6 名健康的生育妇女。RIF 的定义为在三个或更多新鲜或冷冻周期中转移四个优质胚胎后仍未怀孕。
RIF 患者和对照组妇女在周期 LH+7-LH+9 天取子宫内膜活检样本。通过免疫组织化学检测整合素α₁、α₄和αVβ₃的表达。
通过 H 评分分析，对每种整合素蛋白在腔上皮和腺上皮、基质和血管壁细胞中的表达进行半定量测量。
整合素α₁和α₄在腔上皮和腺上皮细胞及血管壁细胞中的表达最强，且腺上皮细胞中的整合素α₁和α₄表达明显高于腔上皮细胞（H 评分：α₁ 293±15 和 180±12，α₄ 287±14 和 191±11）。上皮和血管中的αVβ₃表达也高于基质，但在腺上皮和腔上皮中αVβ₃的表达无显著差异。在 RIF 患者和对照组妇女的子宫内膜各部位中，α₁、α₄和αVβ3 表达的 H 评分无显著差异。在随后的辅助受孕治疗后获得临床妊娠的（n=21）和未成功的（n=24）患者的任何部位的α₁、α₄和αVβ₃表达均无显著差异。
当定义为在三个转移周期中至少转移四个优质胚胎后仍未获得临床妊娠时，RIF 与子宫内膜整合素表达异常无关。此外，整合素α₁、α₄和αVβ₃的表达在随后的 IVF 治疗中似乎没有预后价值。
